MSK - Hip

Question 1

“What are you looking for on General Inspection?”

Answer 1

• Body Habitus - RF for Osteoarthritis
• Scars
• Peripheral Paraphenlia i.e. Medications, Prescriptions, Walking Aids

Question 2

“What are you looking for on Closer Inspection?”

Answer 2

Anterior

• Bruising
• Swelling
• Quadriceps Wasting
• Leg Length Discrepency
• Pelvic Tilt (Scoliosis, Leg Length Discrepancy, Hip Abductor Weakness)

Lateral
- Flexion Abnormalities

Posterior
- Muscle Wasting (Posterior Thigh or Gluteal Region)

Question 3

“Describe the 6 steps in the normal Gait Cycle?”

Answer 3

1. Heel-strike:initial contact of the heel with the floor.
2. Foot flat:weight is transferred onto this leg.
3. Mid-stance:the weight is aligned and balanced on this leg.
4. Heel-off:the heel lifts off the floor as the foot rises but the toes remain in contact with the floor.
5. Toe-off:as the foot continues to rise the toes lift off the floor.
6. Swing:the foot swings forward and comes back into contact with the floor with a heel strike (and the gait cycle repeats).

Question 4

“Describe some Abnormal Gaits?”

Answer 4

Hemiparetic Gait - Unilateral UMNL
Spastic Paraparesis - Bilateral UMNL

Trendelenburg Gait - Unilateral Hip Abductor
Waddling Gait - Proximal Myopathy
High Stepping Gait - Peripheral Motor Neuropathy
Ataxic, Stamping Gait - Peripheral Sensory Neuropathy

Ataxic, Broad Based Gait - Cerebellar Disorder
Parkinsonian Gait - Shuffling
Ataxic - Parkinsonian - Broad Based, Shuffling

Question 5

“What may cause pain on palpation of the Greater Trochanter?”

Answer 5

Trochanteric Bursitis

Question 6

“Describe some Special Tests in the Hip Examination?”

Answer 6

Thomas’ Test - Fixed Flexion Deformity

Trendelenburg Test - Unilateral Hip Abductor Weakness